Submission ID 118411
| Issue/Objective | In Uganda, measles outbreaks persist due to challenges in public health infrastructure, vaccine coverage, and socio-economic factors. Moroto District reported a measles outbreak in April 2024 affecting all the 8 sub-counties in the district. We conducted an investigation between April and 21st July 2024 to assess the burden of the measles outbreak and identify the predisposing factors in the most affected sub-counties. |
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| Methodology/Approach | A suspected case of measles was defined as any person with fever and maculopapular rash with at least cough, coryza, or conjunctivitis and a confirmed case was a suspected case with a laboratory-confirmed positive measles IgM. For descriptive analysis, medical records from health facilities in three high-burden sub counties in Moroto were reviewed to generate a line list of both the suspected and confirmed cases from April to July 2024. To ascertain the possible predisposing factors for measles in Moroto District, we conducted key informant interviews with district health officials. Descriptive statistics were conducted using Microsoft Excel. |
| Results | One hundred eighty measles cases were recorded in the three health facilities, with no deaths. Females comprised 53% (95/180), the mean age was 4.5(±9.4), and the highest number of measles cases 81.7% (147/180) were among children aged 0-4 years. Geographically, the highest attack rate was reported in Lotisan Sub-county (33/1000 population), followed by Rupa Sub-county (16/1000 population) with a peak of admissions in July (36 cases) and Nadunget Sub-county (6/1000 population). Based on the interviews, the Moroto district outbreak was linked to low vaccination coverage, high malnutrition rates in children under the age of five, poor housing conditions, and cross-border movement from Turkana-Kenya, a county that had an ongoing measles outbreak. |
| Discussion/Conclusion | The Moroto measles outbreak primarily impacted children under five, highlighting their vulnerability. A spike in cases in July was linked to the influx of pastoralists from Turkana-Kenya seeking water and pasture in Lotisan Sub- County. Contributing factors included; low vaccination coverage, high malnutrition rates, poor housing conditions, and cross-border movements. Effective risk communication, multi-sectoral collaboration, and enhanced vaccination efforts are crucial for controlling the measles spread and preventing future outbreaks in the district. |
| Presenters and affiliations | Angela Kisakye Makerere University School of Public Health Mary Ajumo Makerere University School of Public Health Wilson Tusiime Makerere University School of Public Health Bernard Lubwama Ministry of Health Uganda Suzanne Kiwanuka Makerere University School of Public Health |
